Individual provider Active NPI

Mary Elizabeth Hartwig, PH. D., APN

  • Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1386759660
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AO1219ANP Issued in AR
Practice address
223 E Jackson Ave
Jonesboro, AR 72401-3119
Phone
(870) 972-0063
Fax
(870) 930-2914
NPI assigned
Aug 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AO1219ANP AR Primary

Addresses

Primary practice location

223 E Jackson Ave
Jonesboro, AR 72401-3119

Mailing address

223 E Jackson Ave
Jonesboro, AR 72401-3119
Phone (870) 972-0063

Other identifiers 1

IdentifierTypeStateIssuer
AO1219ANPOtherARSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AO1219ANPARMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386759660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-972-0063",
            "fax_number": "870-930-2914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-972-0063",
            "fax_number": "870-930-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWIG",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "PH. D., APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "AO1219ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "AO1219ANP",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.